Medical images in digital form play a vital role in today's patient care environment. It is conceivable that digital images will replace totally film images in the future. Our present grant investigated the clinical efficacy of computerized acquisition, transmission, storage, retrieval and display of portable chest radiographic images to the Medical Intensive Care Unit (MICU). All events related to the production and review of images were recorded and analyzed. Various time intervals between the time the examination was requested and the time a clinical action was taken were studied to compare the film and digital systems. The digital system was well-utilized and appreciated by the MICU physicians. Although much effort was applied to the man-machine interface, there was still some reluctance to use the system. The development of an new image viewing philosophy and an effective display console to facilitate this process is essential to the success of a digital system for review and diagnosis. We have identified three areas of research which could facilitate such a development. These are the determination of: The design of an effective user interface; The clinical utility of contrast functions; The clinical utility magnification and rove functions. The mechanisms for image acquisition, transmission and archiving as well as the data collection and analysis procedures are already in place and are fully functional. This research project will have three concurrent streams of activity. Various software modules will be first tested in a laboratory, then clinically tested by radiologists and finally clinically evaluated in the Medical and Cardiac Intensive Care Units.